APPLICATION CHECKSHEET
Project Information Memorandum (PIM)
Address:
Use this checksheet to assist you in lodging a complete PIM application and to avoid delays in processing. This
checksheet shows you the minimum information that has to be supplied with your application. Please complete each
box in the Customer use column as you attach the information. Complete all sections using either a  or Y where the
information is provided, or a X or N/A where the information is not applicable to the building work proposed as shown on
the key at the bottom of each page.
Customer
use
1. GENERAL
COMPLETE FOR ALL APPLICATIONS
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a. Application Form B-002R or B-002C:

Complete all sections and signed by the owner or by an agent on behalf of the owner.
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b. Proof of Ownership:
A recent copy of each current certificate(s) of title (i.e. not older than 6 months) and where applicable a
copy of purchase agreement (if recently purchased) or a copy of relevant portions of current lease.

CT available at Christchurch City Council for a fee.
Required
yes /
no (applicant to complete)
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c. Application Fee:

Application will not be accepted without payment of the appropriate fees. Fees payable are set out
in the published Fee Schedule B-301.
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d. Site Plan (1:200) showing:

Boundary dimensions, north point, legal description, site area.

Known easements, right-of-ways, waterways, heritage/archaeological information.

Physical location of all existing and proposed buildings in relation to streets and boundaries with
building setbacks dimensioned and building areas noted.

Street trees, poles, sumps, communication boxes, traffic islands.

Hill/sloping sites – ground contours, drive gradients, extend of cut and fill, retaining walls.

City Plan requirements – living/service courts, landscape areas (L3, L4 zones), recession plane
locations, site coverage %.

Rural sites: Total impervious surface areas including all buildings and hard standing areas.
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e. Levels showing: (NOTE: WHERE INUNDATION OF THE PROPERTY COULD BE AN ISSUE, THE LEVELS AND
THE ASSOCIATED BENCHMARK MUST BE IN TERMS OF THE CHRISTCHURCH CITY DATUM OR FOR THE
BANKS PENINSULA AREA MEAN SEA LEVEL IN TERMS OF THE LYTTELTON 1937 DATUM.)


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Key:
]
f.
Existing and proposed site levels and proposed finished floor levels (especially at critical points
where required to show City/District Plan compliance).
On hill sites provide a registered surveyor’s certificate confirming the existing site levels.
Floor Plan (1:100/1:50) showing:

Designated spaces.

Overall dimensions.
 or Y = provided
LU: 30.01.13, LR: 23.06.13, v2
X or N/A = not applicable to job
1 of 2
Form B-061
Customer
use
1. GENERAL (continued)
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g. Elevations (1:100/1:50) showing:

Recession planes from accurate levels.

Maximum height.

Doors and windows.

Floor levels and ground contours.
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h. Vehicle Access Plans showing:

Location and extent of driveway relative to existing legal boundaries of the site and public
footpath/roadway.

Long-section (1:100) showing proposed levels and gradients along the centreline; on hill sites.

Location and area of parking spaces.

Turning circles.

Trees, street furniture, lamp posts, manholes, bus stops, telecommunication boxes, etc.
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i.
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j.
Gas Supply:
Reticulated or bottled?
Gas bottle locations and capacities.


Hazardous Substances and Processes: (COMPLETE FOR ALL PROJECTS WHERE THE BUILDING USE
INVOLVES THE STORAGE, OR USE OF OR PROCESSING WITH HAZARDOUS SUBSTANCES.)
Hazardous substances include explosive, radioactive, toxic or flammable materials and
compressed gases. (Common examples are diesel and LPG.)

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k.
Food Premises: (COMPLETE FOR ALL PROJECTS WITH AN INTENDED USE INCLUDING THE
MANUFACTURE, STORAGE, PREPARATION OR SALE OF FOOD PRODUCTS.)




Key:
Provide details of the materials used or stored, their hazardous substance classification (HSNO),
individual container size and aggregate volume.
Indication of type of business, e.g. Kitchen, Café, Restaurant, Bar.
Number of staff.
Number of patrons (seated and standing).
Designation of proposed use for each area.
 or Y = provided
LU: 30.01.13, LR: 23.06.13, v2
X or N/A = not applicable to job
2 of 2
Form B-061